Effects of Pancreatic Duct Stenting on Nutrition and Pancreatic Function in Unresectable Pancreatic Cancer: A Pilot Study.

[AIMS] Malnutrition due to pancreatic enzyme insufficiency and cancer-related systemic effects is common in advanced pancreatic cancer and worsens survival. Pancreatic duct stenosis can lead to obstructive pancreatitis, enzyme elevation, and nutritional decline. In this study, we aimed to evaluate the impact of transpapillary pancreatic duct stenting in patients with unresectable pancreatic cancer.

[METHODS AND RESULTS] This retrospective study included patients with obstructive pancreatitis or pancreatic enzyme elevation due to pancreatic duct stenosis caused by unresectable pancreatic cancer who underwent transpapillary pancreatic duct stenting at Osaka International Cancer Center (November 2020-July 2022). Patients were selected based on specific criteria, including available computed tomography scans 3 months post-stenting and continued chemotherapy. Nutritional, clinical, and pancreatic structural changes were assessed 3 months after stent placement. The Wilcoxon signed-rank test was used for statistical analysis. All 10 patients achieved clinical success without complications. The main pancreatic duct diameter significantly decreased at the body (5.8 to 3.6 mm;  = 0.004) and tail (3.8 to 2.0 mm;  = 0.025); however, pancreatic parenchymal thickness remained stable. Nutritional markers showed a trend toward improvement, with a significant gain in body weight from 47.2 to 48.6 kg ( = 0.048).

[CONCLUSION] Pancreatic duct stenting may be associated with improvements in nutritional status and the maintenance of pancreatic structure in patients with unresectable pancreatic cancer, suggesting a potential role in managing pancreatic enzyme insufficiency and malnutrition.